Why & How to Find a Midwife or Doula July 21, 2009

When you’re pregnant (if not before) you’ve got to investigate all of your options.  Is your OB-GYN making you feel comfortable and capable?  Finding time to answer all of your questions?  Helping you prepare emotionally and intellectually for childbirth?  If you’re not happy with your current caregiver, it’s not too late to make big changes (provided you’re not already 36 weeks!). 

A midwife’s model of care is totally different than an OB-GYN.  While an OB is trained to be well-versed in medical ways to address problems during childbirth, a midwife is trained to appreciate the process of childbirth as a natural, powerful and sacred event.  And, she brings natural tools for addressing problems and pain of which an OB is often completely unaware.  An OB views birth as something to be controlled or “made-safe”.  A midwife views birth as something to gently assist (both physically and emotionally)  and respect – it’s already safe in most cases. 

Of course, these are just generalizations – there are many exceptions to the rule.  The first midwife I interviewed was discouraging and controlling!  But, the other two I hired were wise, respectful and reassuring.  I encourage you to consider the care of a midwife and/or that of a doula, who can make a tremendous difference in how you’ll feel about your birth experience.  Each birth is a unique, miraculous experience that only occurs once.  It’s yours to be enjoyed – yes, really!

Here are some great links for beginning your search:

http://www.midwife.org/
http://cfmidwifery.org/index.aspx
http://www.dona.org/mothers/index.php

Create Your Birth Plan, Earth Mamas! January 29, 2009

If you’re having a hospital or birth center birth, you will have caregivers who have no idea about your desires and plans.  A birth plan is WONDERFUL for communicating all the minutae.  Minutae?  What minutae?  Ah, I see you haven’t taken a look at Earth Mama Angel Baby’s free online birth plan system yet.  It’s easy-to-use, free, and produces a nice save-able and printable copy of your custom birth plan.  And, even more, it’s a great tool to help you think through all of the many choices you’ll face during labor, immediately postpartum and as a new mother.

Home Birth for a Healthy Baby September 7, 2008

Both of my children were born at home, with midwives attending.  Why?  Because I felt it was the best choice for my baby’s health and for my own well-being.  I’m not alone.  Check-out this interesting post about another woman’s choice to birth at home:  http://birthisgood.blogspot.com/2008/09/home-birth-for-healthy-baby.html.

Doctor’s push to Outlaw Home Birth June 21, 2008

On monday the American Medical Association (AMA) resolved to introduce legislation outlawing home birth, and potentially making criminals of the mothers who choose home birth with the help of Certified Professional Midwives for their families.  What?!?  At a time when the UK is pushing for MORE mothers to choose home birth, the American Medical Association (AMA) wants to take away a woman’s right to choose home birth accompanied by a licensed professional!

Why?  The AMA says that the hospital is the best place for birth.  That’s a shocking statement, given the overwhelming evidence that most women have better outcomes when attended by a midwife at home.  When healthy women partner with a midwife to birth at home, 95% give birth vaginally, with hardly any intervention.  Compare that to the escalating C-section rates in our country!  The AMA offered no evidence to support it’s claim.  Since maternity care is a multi-billion dollar industry in the United States, one can’t help but surmise that their motivation is not pure. 

“Research evidence be damned, the doctors want to mandate you to go to the hospital. They don’t want you to have a choice.

We think they’re spooked. The cesarean rate is rising, celebrities are publicizing their home births (the initial wording of the AMA resolution actually took aim at Ricki for publicizing her home birth on the Today Show!), people are reading Pushed and watching The Business of Being Born, and there’s a nationwide legislative “push” to license certified professional midwives in all states (The AMA is against that, too, by the way).

The docs are on the defensive.

After all, birth is big business — it’s in fact the most common reason for a woman to be admitted to the hospital. And if more women start giving birth outside of it, who will get paid? Not doctors and not hospitals.”

from Docs to Women: Pay No Attention to Ricki Lake’s Home Birth.

The Business of Being Born May 15, 2008

This weekend I watched Ricki Lake’s documentary, “The Business of Being Born”.  I was absolutely blown away by the clarity and gentleness by which the film discussed what is so often a messy topic: what should birth and maternity care look like?  

The film brought together the voices of OB/GYN’s, Labor & Delivery Nurses, Midwives, Pregnant women and Postpartum mothers to take a fair, unbiased look a the issues at hand.  What issues, you say?  Well, when you look at the stats on maternal mortality, infant mortality, and c-section rates, the United States trails most every ”developed” country and even lags behind certain “undeveloped” countries.  And this despite the fact that Americans put soooooooo much more money into maternal and infant healthcare!  We pay more and get less.  What’s going on here? 

You have GOT to watch the film to find out, but here’s a taste of the action from the director, “When my friend Ricki Lake approached me about making this film, I admitted to her that I was afraid to even witness a woman giving birth, let alone film one. I had never pronounced the word “midwifery” and I thought Ricki insane, as she planned the birth of her second child, for passing up an epidural in a hospital delivery.

But as I did the research, I discovered that the business of being born is another infuriating way medical traditions and institutions – hospitals and insurance companies – actually discourage choice and even infringe on parents’ intimate rites, ultimately obstructing the powerful natural connection between mother and newborn child.”

I LOVED THIS VIDEO!  If you’re pregnant, you should watch it.  It’ll give you such a realistic preview of what healthy birth looks like, including all types of normal births from vaginal to breach to medically necessary c-section.  It was inspiring to the point of tears, and entirely real through and through.  Before you make your birth plan, watch ”The Business of Being Born”!  

The Best Prep for a Non-Medicated Birth April 15, 2008

Many women desire to give birth without pain medication, or at least with as few heavy medications as possible.  How do you prepare yourself for that challenge?  What makes the difference between a woman who throws out her birth plan and gets that epidural and the one who manages her pain in the way she had hoped? 

For one, you have to realize that women feel contractions differently.  Some experience contractions as extremely painful, but others just feel tightness or almost nothing at all.  My friend Chihiro said she couldn’t even tell when she was contracting with her first baby, but with the second she experienced intense pain.  Prepare yourself by keeping an open mind to how easy or difficult the actual experience may be for you.  It’s completely unpredictable.

That said, countless women who experience intense pain during labor do manage to forgo medicating.  Now, I realize that a non-medicated birth isn’t for everyone, but if this is one of your goals here are some tips:

1. Limit your exposure to medication opportunities.  Really.  If you don’t want to take drugs, try to avoid having them offered to you.  When you enter the labor room, personally tell the nurse that you prefer she NOT offer you medication.  Ask your birth partner to keep new nurses updated.  I heard of one woman who hung a “Don’t Offer Me Medication” sign on her labor room door.  Hey, it’s easier if you don’t have to say “no”.  If you really, consciously change your mind, I bet you’ll find the words to ask for that medication!
2. Train your mind to think of birth positively.  Birth is an opportunity to bond with your mate, work hard for something worthwhile, experience the thrilling joy of success hard-won, and embrace that new baby for the first time.  Read LOTS of natural birth stories!  This is the most enjoyable and probably the most effective way to prepare for a natural, non-medicated birth.  Each time you expose yourself to stories of women who experienced birth like you desire, you set yourself up to approach birth with a positive, confident attitude. 
3. Prepare to be flexible.   Your birth will probably NOT go exactly as planned.  Maybe your contractions will stop temporarily. Maybe your doula will not make it.  Maybe your labor will drag on for over 24 hours.  Maybe you’ll go from 2 to 10 centimeters in an hour – who knows!!!  It’s great to have a plan, but be prepared to throw it out the window.  Spend some time imagining very different possibilities and how you would like to react.  No matter what happens, you can have a fulfilling birth experience if you keep your perspective positive and take control of your choices.  In birth you are not the victim or the patient, you are the mom.
4. Gain access to alternative pain management options.  If you’re saying “no” to drugs, say “yes” to something else! Read, talk to other moms about what worked for them, and arrange for the services of a midwife or doula.  There is a rich culture of birthing aids from warm water to massage to visualizations that can make a huge difference in your perception of pain during labor.  Your labor nurse is very unlikely to be of help in this area.  You’ve got to proactively plan ahead to arm yourself with safe, effective labor tools.  Again, reading positive natural birth stories is an excellent way to fill your mind with pain management ideas. 

Bottom line: managing pain is 90% mental.  The difference between achieving your goal to birth without drugs and making a decision to medicate that you may regret is usually how prepared you are mentally.  Know that you can do this.  Focus on the positives and let every contraction bring you closer to holding that baby in your arms.

One great classic full of positive birth stories is Ina May Gaskin’s ”Ina May’s Guide to Childbirth”.  You can also find a rich resource of birth stories at Mothering.com. 

Many blessings!

Who will witness your baby’s birth? December 3, 2007

You’ve made a birth plan, you’ve packed your hospital bag (or set aside a stash of supplies for your home birth), but are you still a little fuzzy on who you’d like present at your baby’s birth?  This is a very personal decision, and one that doesn’t necesarilly lend itself to the receiving of advice.  I had a very hard time deciding with both my babies who to include. Perhaps this will get you thinking… 

If one of your goals is to have a natural birth, it’s especially important that those who accompany you in the labor room play a supportive, encouraging role.  I loved this quote in the latest edition of Fit Pregnancy, “For the best possible delivery, surround yourself with people who understand that giving birth is a heroic, if painful, act that benefits those who embrace its challenge.”  Isn’t that beautiful!  Think carefully before including loved ones that are critical of your birth choices.  On birth day, you simply won’t have enough emotional energy to deal with nay-sayers.  You want to see excitement and hope in the eyes of your attendents, never pitty or fear.

You will almost certainly be including your mate, but what about sisters, mothers, and friends?  Don’t feel obligated to invite family members.  Your first priority must be giving birth, not the feelings of others.  That said, if you are close to your sister (and especially if she’s given birth before) or your mother, their presence will probably enhance that special day.  My mother was a very important member of my birth team when I birthed my firstborn.  During the times that I felt hopeless and scared, looking into her face gave me strength.  There is something powerful about being supported in birth by the very one who birthed you.     

When I read of births in which mothers were attended by excited, joyful friends, I love it, love it, love it!  But in planning my own birth, I felt odd inviting friends.  For my second birth I did get up the gumption to invite a close friend who shared my own vision of birth.  Technically she was there to watch my toddler, but she also was meant to share the actual birth.  During my labor, it was fun having her there.  It made that night more like a celebration, less serious and more exciting.  When I was actually giving birth, I barely noticed her presence because I was so focused on the task at hand.  If I was to do it again, I’d invite more friends and make the labor itself more of a party!

Don’t skip a doula!!!  If you can arrange for it, do look into having a doula attend your birth.  There’s nothing like it!  Having a doula around at my second birth took the pressure off my husband to know how to comfort me.  She helped him with suggestions and did so much to help me herself.   I would never go without a doula again!

Many blessings on your special day!

 

    

Common Hospital Practices are Counterproductive October 25, 2007

I was so happy to see this column in the October/November issue of Fit Pregnancy, “For low-risk women, common hospital practices such as labor induction do not improve health outcomes for mothers or babies and often cause harm.  Electronic fetal monitoring, nonemergency Cesarean sections, routine use of IV fluids, amniotomy (breaking the bag of waters), withholding food and water and episiotomy were all found to have adverse effects on mother, baby or both.  The study, “Evidence Basis for the Ten Steps to Mother-Friendly Care,” found that inducing labor increases fetal distress and that babies born after elective inductions are more likely to require admission to a neonatal intensive care unit. To avoid these problems, the researchers recommend midwifery care for low-risk women. – Erica Jorgensen The Journal of Perinatal Education.”   

Granted there is a place for most of these common hospital practices.  The point is that you should push for a natural birth, delaying interventions such as induction or Cesarean until they are absolutely necessary, as this is what’s best for you and for baby.  It is sad, but true that sometimes caregivers are more interested in their convenience then your best outcome – doctors and nurses are only human.  Be your own advocate for a safe, healthy birth!